Tag Archives: delayed cord clamping

Recently, my repeat client had a repeat breech. I blogged once before about this amazing woman.

As you know, in the US, it is impossible challenging to find an OB willing to manage a vaginal breech birth. Heading into a repeat cesarean, this mama did her research and opened a dialogue with her OB about her choices.

I’m delighted to report that Dr. Cowart with Greer OB supported her choice to wait 1 minute before clamping the cord and to have baby placed skin-to-skin. She enjoyed skin-to-skin contact for over an hour after her baby’s birth.

I hesitate in posting this because I’m afraid Greer OB will be overrun with families who want choices in their births! Soon, they might become like Dr. Polo Shirt who is so busy he’s turning expectant families away.

Thank you to this mama who maybe blazed a trail for other women to have this conversation! And congratulations on your beautiful baby!

“Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child.”

–Erasmus Darwin, 1801

I’m a big believer in physiological processes. They usually work. If my digestion is working, there is no need to mess with it. Likewise, birth is a normal event. We don’t grow a cord clamp or pair of scissors that are magically delivered when we give birth. Heck, that pesky cord doesn’t even have snaps or velcro for easy detachment. Did you know that changes in the Wharton’s jelly will create an internal clamping within about 10-20 minutes of birth? If left completely alone (i.e. lotus birth), the cord will, in fact, detach on its own in 2 or 3 days.

Was it meant to be cut within seconds of birth?

What about the baby’s blood that is circulating through the cord and the placenta?

What does it mean for the baby when she doesn’t get that blood back?

What does it look like for the baby who has received oxygen via her cord and suddenly must transition to breathing air?

Who has the burden of proof here?

Hmmmm, there must be a reason why the umbilical cord continues pumping for a few minutes after the baby is born.

I caught that line from an overheard snippet of House M.D. recently. Someone told House to get consent before a procedure. He sarcastically replied something to the effect: Start getting consent for procedures and soon they’ll be asking for informed consent.

Well there is a new tool in the informed consent workshop. Released this week, the Milbank Report: Evidence-Based Maternity Care Report has the US abuzz. Consumer Reports even released a report on the findings. One of the quotes I love in the Milbank report’s executive survey is “The many beneficial, underused practices around the time of birth include continuous labor support, numerous measures that increase comfort and facilitate labor progress, nonsupine positions for giving birth, delayed cord clamping, and early mother-baby skin-to-skin contact.” Humph. Nonsupine positions, delayed cord clamping, and immediate skin-to-skin are usually the most difficult concessions to get in hospital births I attend. There is always some reason why it can’t be done.

The sum-up of the findings seems to be hire a family practice physician or midwife to attend your birth, hire a doula, and know which processes are evidence-based. Not sure how to discern evidence-based practices? I usually go first to the Cochrane Database of Systematic Reviews.